TY  - JOUR
PY  - 2019//
TI  - Clinical determinants of fitness to drive in persons with multiple sclerosis: systematic review
JO  - Archives of physical medicine and rehabilitation
A1  - Krasniuk, Sarah
A1  - Classen, Sherrilene
A1  - Morrow, Sarah A.
A1  - Tippett, Marisa
A1  - Knott, Melissa
A1  - Akinwuntan, Abiodun
SP  - 1534
EP  - 1555
VL  - 100
IS  - 8
N2  - OBJECTIVE: To critically appraise the evidence for the clinical determinants of fitness to drive in adults with Multiple Sclerosis (MS). DATA SOURCES: The research librarian and lead author searched seven databases for driving simulator and on-road studies for adults with MS published in the English language from 1991 to 2018. STUDY SELECTION: Three reviewers independently screened titles/abstracts and full-texts for studies with: cohort, case-control, or cross-sectional designs; participants, 18 years or older, with relapsing or progressive MS; visual, cognitive, or motor clinical assessments as predictors; and driving performance through simulator or fitness to drive through on-road assessment as outcomes. DATA EXTRACTION: Using the 2017 American Academy of Neurology guidelines, reviewers independently classified each study from Class I-highest to Class IV-lowest amount of rigor. For each clinical assessment, reviewers independently rated the level of confidence for predicting driving performance or fitness to drive from Level A-highly probable, B-probable, C-possible, to Level U-insufficient conclusions. DATA SYNTHESIS: Through qualitative synthesis, two Class III and four Class IV driving simulator studies employed twenty-four clinical assessments with Level C (n=4) or Level U (n=20) confidence for predicting driving performance. Six Class II and three Class IV on-road studies employed thirty-five clinical assessments with Level B (n=9), Level C (n=22), or Level U (n=4) confidence for predicting fitness to drive. <br><br>CONCLUSIONS: This systematic review identified mostly insufficient conclusions for predicting driving performance in driving simulator studies, and possible conclusions for predicting fitness to drive in on-road studies. The best available evidence suggests that the Stroke Driver Screening Assessment and Useful Field of View™ probably predict fitness to drive in adults with MS (Level B). Class I studies that compare predictors of fitness to drive with large prospective samples of adults with and without MS are necessary for highly probable conclusions.<br><br>Copyright © 2019. Published by Elsevier Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-9993
UR  - http://dx.doi.org/10.1016/j.apmr.2018.12.029
ID  - ref1
ER  -